Autism Spectrum Disorder and Mental Health Challenges in Youth
|
|
- Isabella Freeman
- 5 years ago
- Views:
Transcription
1 Autism Spectrum Disorder and Mental Health Challenges in Youth Management in the Primary Care Setting February 13, 2016 Rebecca Marshall, MD, MPH
2 Outline DSM V Criteria Comorbidities Behavioral treatments Pharmacologic treatments Resources 2
3 Autism Spectrum Disorder DSM IV DSM V Autistic Disorder, Asperger s Disorder, and PDD-NOS replaced with Autism Spectrum Disorder (ASD). Three core domains of impairment (communication, social interaction, and restricted interests and repetitive behaviors) changed to two domains of impairment: social/communication deficits and restricted interests and repetitive behaviors. Also, a delay in language development is no longer necessary for a diagnosis. 3
4 DSM V Autism Spectrum Disorder Criteria A. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by: 1. Deficits in social-emotional reciprocity, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions. 2. Deficits in nonverbal communicative behaviors used for social interaction, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication. 3. Deficits in developing, maintaining, and understanding relationships, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers. Specify current severity. Severity is based on social communication impairments and restricted repetitive patterns of behavior. 4
5 DSM V Autism Spectrum Disorder Criteria B. Restricted, repetitive patterns of behavior, interests, or activities: 1. Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypies, lining up toys or flipping objects, echolalia, idiosyncratic phrases). 2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns or verbal nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat food every day). 3. Highly restricted, fixated interests that are abnormal in intensity or focus (e.g, strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interest). 4. Hyper- or hyporeactivity to sensory input or unusual interests in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling ortouching of objects, visual fascination with lights or movement). Specify current severity: Severity is based on social communication impairments and restricted, repetitive patterns of behavior (see Table 2). 5
6 DSM V Autism Spectrum Disorder Criteria C. Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life). D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning. E. These disturbances are not better explained by intellectual disability or global developmental delay. Intellectual disability and autism spectrum disorder frequently cooccur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level. Note: Individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger s disorder, or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder. Individuals who have marked deficits in social communication, but whose symptoms do not otherwise meet criteria for autism spectrum disorder, should be evaluated for social (pragmatic) communication disorder. 6
7 7 ASD and Comorbid Psychiatric Disorders 2008 prevalence study in JAACAP 112 children with ASD ages were assessed for other psychiatric disorders. 70% had at least one comorbid disorder Emily Simonoff, Andrew Pickles, Tony Charman, Susie Chandler, Tom Loucas, Gillian Baird, Psychiatric Disorders in Children With Autism Spectrum Disorders: Prevalence, Comorbidity, and Associated Factors in a Population- Derived Sample, Journal of the American Academy of Child & Adolescent Psychiatry, Volume 47, Issue 8, August 41% had two or more. 2008, Pages
8 ASD and Comorbid Psychiatric Disorders Most common diagnoses: social anxiety disorder (29.2%) attention-deficit/hyperactivity disorder (28.2%) Oppositional defiant disorder (28.1 %) Generalized anxiety disorder (13.4%) Panic disorder (10.1%) Enuresis (11%) Low rates of major depressive disorder (0.9%), dysthymic disorder (0.5%), and conduct disorder (3.2%) 84% of those with ADHD had a second comorbid diagnosis. 8
9 Psychiatric comorbidity with ASD Fig. 1. Weighted rates of comorbidity are shown for all of the disorders and for all of the main disorders, in which the latter includes ADHD, oppositional defiant or conduct disorder, and any emotional disorder 9 Emily Simonoff, Andrew Pickles, Tony Charman, Susie Chandler, Tom Loucas, Gillian Baird, Psychiatric Disorders in Children With Autism Spectrum Disorders: Prevalence, Comorbidity, and Associated Factors in a Population-Derived Sample, Journal of the American Academy of Child & Adolescent Psychiatry, Volume 47, Issue 8, August 2008, Pages
10 Intellectual disability in those with ASD approximately 50% exhibit severe or profound intellectual disability 35% exhibit mild to moderate intellectual disability, and the remaining 20% have IQs in the normal range.18 Fred Volkmar, Matthew Siegel, Marc Woodbury-Smith, Bryan King, James McCracken, Matthew State, and the AACAP Committee on Quality Issues. Practice Parameter for the Assessment and Treatment of Children and Adolescents With Autism Spectrum Disorder. JAACAP, 53 (2)
11 Behavioral difficulties in those with ASD A range of behavioral difficulties can be observed in ASD: hyperactivity obsessive-compulsive phenomena self-injury aggression stereotypies Tics affective symptoms (lability, inappropriate affective responses, anxiety, and depression) 11
12 Behavioral Treatments for ASD Core feature of ASD is difficulty with social interactions. 12 Therapy / behavioral treatments therefore critical with strong evidence base for improved outcomes.
13 Applied Behavior Analysis Based on concept of understanding how events influence and change behavior. Requires assessment of how events influence an individual s behavior. Includes: contextual factors such as the setting in which a behavior occurs; motivational variables such as the need to attain something; antecedent events, such as a request to do something from another person; Consequences following the behavior Progress is measured by direct observations over time. Early Intensive Behavioral Intervention (EIBI) -- comprehensive ABA program for young children Intensive and highly individualized Up to 40 hours per week of one-to-one direct teaching 13 Reichow, B. & Volkmar, F.R. Social skills interventions for individuals with autism: evaluation for evidence-based practices within a best evidence synthesis framework. Autism Dev Disord (2010) 40: 149.
14 Naturalistic treatment Used to structure parent child interactions or to teach imitation and/or joint attention behaviors Intervening in the natural environment with natural reinforcers during interactions guided by the child Evidence strongest for use with young children Reichow, B. & Volkmar, F.R. Social skills interventions for individuals with autism: evaluation for evidencebased practices within a best evidence synthesis framework. Autism Dev Disord (2010) 40:
15 Parent Training Important element of intervention programs for children with autism Accumulating evidence that parent training is an effective method for increasing the social skills of young children Reichow, B. & Volkmar, F.R. Social skills interventions for individuals with autism: evaluation for evidencebased practices within a best evidence synthesis framework. Autism Dev Disord (2010) 40:
16 Peer training The use of peers to help teach children with autism has been a commonly used method that has significant research support Used for both preschool and school-aged children Like-aged individuals with and without individuals Peers taught to provide specific elements of therapy including visual supports and prompting Reichow, B. & Volkmar, F.R. Social skills interventions for individuals with autism: evaluation for evidencebased practices within a best evidence synthesis framework. Autism Dev Disord (2010) 40:
17 Other modalities Visual supports (social stories, visual schedules) Social skills groups Video modeling Occupational / physical therapy 17
18 Communication 18 Typically addressed in the child s IEP in coordination with the speech-language pathologist. Nonverbal children: alternative communication modalities, i.e., sign language, communication boards, visual supports, picture exchange. Children with fluent speech: language skills training, for example targeting pragmatic Fred Volkmar, Matthew Siegel, Marc Woodbury-Smith, Bryan King, James McCracken, Matthew State, and the AACAP language Committee on Quality skills. Issues. Practice Parameter for the Assessment and Treatment of Children and Adolescents With Autism Spectrum Disorder. JAACAP, 53 (2) 2014.
19 Educational Children with ASD need a structured educational approach with explicit teaching. Programs should involve planned, intensive, individualized intervention with an experienced interdisciplinary team of providers, and family involvement Educational plan should include an assessment of child s strengths and vulnerabilities, with a description of services to be provided, goals and objectives, and monitoring plan Curricula should enhance verbal and nonverbal communication, academic skills, and social, motor, and behavioral capabilities. Fred Volkmar, Matthew Siegel, Marc Woodbury-Smith, Bryan King, James McCracken, Matthew State, and the AACAP Committee on Quality Issues. Practice Parameter for the Assessment and Treatment of Children and Adolescents With Autism Spectrum Disorder. JAACAP, 53 (2)
20 Pharmacotherapy Target specific symptom or comorbid condition Combining medication with parent / behavioral training is more efficacious than medication alone for decreasing serious behavioral disturbance and improving adaptive functioning. Individuals with ASD may be nonverbal, so treatment response is often judged by caregiver report and observation of specific behaviors. Use objective rating scales to help monitor treatment response. SSRIs, atypical antipsychotic agents, stimulants, and α 2 - adrenergic agonist antihypertensive agents are the most commonly prescribed classes of psychotropic medications for children with ASDs. Fred Volkmar, Matthew Siegel, Marc Woodbury-Smith, Bryan King, James McCracken, Matthew State, and the AACAP Committee on Quality Issues. Practice Parameter for the Assessment and Treatment of Children and Adolescents With Autism Spectrum Disorder. JAACAP, 53 (2)
21 SSRIs Double-blind, placebo-controlled trials have demonstrated efficacy of the SSRIs fluoxetine and fluvoxamine in the treatment of repetitive and other maladaptive behaviors in patients with ASDs Open-label trials of these and other SSRIs have shown improvements in target symptoms, including repetitive behaviors, irritability, depressive symptoms, tantrums, anxiety, aggression, difficulty with transitions, and aspects of social interaction and language. Potential adverse effects of SSRIs include but are not limited to nausea, drowsiness, sexual dysfunction, constipation, abdominal discomfort, fatigue, headache, dizziness, dry mouth, agitation, behavioral activation, hypomania or mania, apathy, suicidal ideation, and alteration of sleep. Myers, SM, Plauche Johnson, C. Management of children with autism spectrum disorders. Pediatrics 120 (5), 2007, 21
22 Antipsychotics Risperidone (2006) and aripiprazole (2009) FDA approved for symptomatic treatment of irritability Includes aggressive behavior, deliberate self-injury, and temper tantrums in children and adolescents with ASDs. Two large, multisite, randomized, controlled trials have confirmed the short-term efficacy of risperidone for these severe disruptive behaviors in youth with ASDs Potential adverse effects include but are not limited to excessive appetite and weight gain, insulin resistance, dyslipidemia, hyperprolactinemia, extrapyramidal symptoms, tardive dyskinesia, neuroleptic malignant syndrome, QTc prolongation, dry mouth, urinary retention, constipation, seizures, hematologic abnormalities, and sedation. 22 Myers, SM, Plauche Johnson, C. Management of children with autism spectrum disorders. Pediatrics 120 (5), 2007,
23 Stimulants 23 A double-blind, placebo-controlled study conducted by the Research Units on Pediatric Psychopharmacology (RUPP) Autism Network (Posey et al., 2004) confirmed earlier findings that about half (49 percent) of children with autism responded to methylphenidate with decreased hyperactivity and inattention. Significantly lower response than for children with ADHD without autism. A large percentage (18 percent) of children with autism treated with methylphenidate experienced significant side effects that were intolerable. Myers, SM, Plauche Johnson, C. Management of children with autism spectrum disorders. Pediatrics 120 (5), Potential 2007, adverse effects include appetite reduction, inhibition of growth, delayed sleep onset, jitteriness, exacerbation of tics, abdominal discomfort, increased blood pressure, increased heart rate, irritability, increased anxiety, and repetitive behaviors.
24 Atomoxetine Some recent studies have suggested that atomoxetine may be effective for attentiondeficit/hyperactivity disorder like symptoms in children and adolescents with ASDs Potential side effects include appetite suppression, nausea, fatigue, mood swings, suicidal ideation, dizziness, and liver injury Myers, SM, Plauche Johnson, C. Management of children with autism spectrum disorders. Pediatrics 120 (5), 2007, 24
25 Alpha-2 agonists Two small double-blind, placebo-controlled trials have documented modest benefits of clonidine in reducing hyperarousal symptoms including hyperactivity, irritability and outbursts, impulsivity, and repetitive behaviors in children with ASDs. Small studies suggested that guanfacine was similarly effective in some patients. Potential adverse effects of these centrally acting α 2 -agonists include but are not limited to drowsiness, sedation, dry mouth, decreased blood pressure, dizziness, constipation, and irritability, and these drugs can be dangerous in overdose. Myers, SM, Plauche Johnson, C. Management of children with autism spectrum disorders. Pediatrics 120 (5), 2007, 25
26 Omega-3s Hypothesis that Omega-3 supplementation should improve symptoms of ASD have not been borne out by research including 2011 Cochrane review. However larger controlled trials are needed. Amminger, GP, Berger, GE, Schafer, MR, Klier, C, Friedrich, MH, Feucht, M. Omega-3 Fatty Acids Supplementation in Children with Autism: A Double-blind Randomized, Placebo-controlled Pilot Study. Biological Psychiatry 61(4); 2001 ( ). 26
27 Sleep Problems There is some evidence of abnormality of melatonin regulation in children with ASDs Melatonin may be effective for improving sleep onset in children with ASDs A recent open-label study suggested that controlled-release melatonin improved sleep in a group of 25 children with ASDs and that treatment gains were maintained at 1- and 2-year follow-up Antihistamines, α 2 -agonists, benzodiazepines, chloral hydrate, trazodone, and newer nonbenzodiazepine hypnotic agents, such as zolpidem and zaleplon, can be trialed Myers, SM, Plauche Johnson, C. Management of children with autism spectrum disorders. Pediatrics 120 (5), 2007, 27
28 Resources for Providers and Parents 28 ASPEN TM, Inc. (Asperger Syndrome Education Network) ( Autism Society of America ( society.org) Autism Speaks ( Division TEACCH (Treatment and Education of Autism and related Communication handicapped Children, University North Carolina at Chapel Hill) ( LDAA (Learning Disabilities Association of America) ( OASIS (Online Asperger Syndrome Information and Support) ( Yale Child Study Center ( A regional nonprofit organization providing families and those individuals affected with Asperger syndrome and related disorders with information, support, and advocacy. The mission of the Autism Society of America is to promote lifelong access and opportunities for persons within the autism spectrum and their families to be fully included, participating members of their communities through advocacy, public awareness, education, and research related to autism. Autism Speaks is an autism science and advocacy organization dedicated to funding research into the causes, prevention, treatments, and a cure for autism; increasing awareness of autism spectrum disorders; and advocating for the needs of individuals with autism and their families. The TEACCH Web site includes information about their program, educational and communication approaches to teaching individuals with autism, their research and training opportunities, and information and resources on autism. The LDAA site includes information and resources on many learning disabilities, including learning disabilities involving a significant social component, such as autism and Asperger syndrome. General information on Asperger syndrome and related disorders, including resources and materials, announcements of major pertinent events and publications, and being the major intersection for communication among parents, clinicians, educators, and individuals with social disabilities Information on autism, Asperger syndrome, and related disorders, lists of resources organized by state, and parent support organizations and advocacy agencies.
29 References Simonoff E, Pickles A, Charman T, Chandler S, Loucas T, Baird G. Psychiatric Disorders in Children With Autism Spectrum Disorders: Prevalence, Comorbidity, and Associated Factors in a Population-Derived Sample, Journal of the American Academy of Child & Adolescent Psychiatry, 47 (8), 2008, Myers, SM, Plauche Johnson, C. Management of children with autism spectrum disorders. Pediatrics 120 (5), 2007, Reichow B. & Volkmar, F.R. Social skills interventions for individuals with autism: evaluation for evidence-based practices within a best evidence synthesis framework. Autism Dev Disord (2010) 40: 149. Volkmar F, Siegel M, Woodbury-Smith M, King B, McCracken J, State M and the AACAP Committee on Quality Issues. Practice Parameter for the Assessment and Treatment of Children and Adolescents With Autism Spectrum Disorder. JAACAP, 53 (2)
30 30 Thank you!
Autism/Pervasive Developmental Disorders Update. Kimberly Macferran, MD Pediatric Subspecialty for the Primary Care Provider December 2, 2011
Autism/Pervasive Developmental Disorders Update Kimberly Macferran, MD Pediatric Subspecialty for the Primary Care Provider December 2, 2011 Overview Diagnostic criteria for autism spectrum disorders Screening/referral
More informationFrom Diagnostic and Statistical Manual of Mental Disorders: DSM IV
From Diagnostic and Statistical Manual of Mental Disorders: DSM IV (I) A total of six (or more) items from (A), (B), and (C), with at least two from (A), and one each from (B) and (C) (A) qualitative impairment
More informationFact Sheet 8. DSM-5 and Autism Spectrum Disorder
Fact Sheet 8 DSM-5 and Autism Spectrum Disorder A diagnosis of autism is made on the basis of observed behaviour. There are no blood tests, no single defining symptom and no physical characteristics that
More informationAutism Diagnosis and Management Update. Outline. History 11/1/2013. Autism Diagnosis. Management
Autism Diagnosis and Management Update Cathleen Small, PhD, BCBA-D Developmental Behavioral Pediatrics Maine Medical Partners Outline Autism Diagnosis Brief history New, DSM-5 diagnostic criteria Expressed
More informationDSM 5 Criteria to Diagnose Autism
DSM 5 Criteria to Diagnose Autism Patient Name Patient Date of Birth Patient Health Plan Provider Name and Credential Date of Exam Only a doctoral level clinician (MD, PhD, and/or PsyD) can complete this
More informationAutism Spectrum Disorder Pre Cengage Learning. All rights reserved.
Autism Spectrum Disorder Pre 2014 2012 Cengage Learning. All rights reserved. DSM- 5 In 2013, the American Psychiatric Association released the fifth edition of its Diagnostic and Statistical Manual of
More informationDSM-IV Criteria. (1) qualitative impairment in social interaction, as manifested by at least two of the following:
DSM-IV Criteria Autistic Disorder A. A total of six (or more) items from (1), (2), and (3), with at least two from (1), and one each from (2) and (3): (1) qualitative impairment in social interaction,
More informationThe Clinical Progress of Autism Spectrum Disorders in China. Xi an children s hospital Yanni Chen MD.PhD
The Clinical Progress of Autism Spectrum Disorders in China Xi an children s hospital Yanni Chen MD.PhD Conception The autism spectrum disorders (ASDs) are neurodevelopmental disability characterized by
More informationTable 1: Comparison of DSM-5 and DSM-IV-TR Diagnostic Criteria. Autism Spectrum Disorder (ASD) Pervasive Developmental Disorders Key Differences
Comparison of the Diagnostic Criteria for Autism Spectrum Disorder Across DSM-5, 1 DSM-IV-TR, 2 and the Individuals with Disabilities Act (IDEA) 3 Definition of Autism Colleen M. Harker, M.S. & Wendy L.
More informationUnderstanding Autism. Julie Smith, MA, BCBA. November 12, 2015
Understanding Autism Julie Smith, MA, BCBA November 12, 2015 2 Overview What is Autism New DSM-5; changes to diagnosis Potential causes Communication strategies Managing difficult behaviors Effective programming
More informationAUTISM SPECTRUM DISORDER: DSM-5 DIAGNOSTIC CRITERIA. Lisa Joseph, Ph.D.
AUTISM SPECTRUM DISORDER: DSM-5 DIAGNOSTIC CRITERIA Lisa Joseph, Ph.D. Autism Spectrum Disorder Neurodevelopmental disorder Reflects understanding of the etiology of disorder as related to alterations
More informationAUTISM: THE MIND-BRAIN CONNECTION
AUTISM: THE MIND-BRAIN CONNECTION Ricki Robinson, MD, MPH Co-Director, Descanso Medical Center for Development and Learning - La Canada CA Clinical Professor of Pediatrics, Keck School of Medicine-USC
More information3/19/2018. Cynthia King, MD Associate Professor of Psychiatry UNMSOM. Autism Spectrum Disorder
Cynthia King, MD Associate Professor of Psychiatry UNMSOM Autism Spectrum Disorder 1 Identify three behavioral health concerns in ASD Identify three common families of medication that may be supportive
More information3/19/2018. Cynthia King, MD Associate Professor of Psychiatry UNMSOM
Cynthia King, MD Associate Professor of Psychiatry UNMSOM 1 2 Autism Spectrum Disorder 3 Identify three behavioral health concerns in ASD Identify three common families of medication that may be supportive
More information11/2/2016 INSIDE THE MIND OF A CHILD PSYCHIATRIST: PROBLEM BEHAVIORS IN CHILDREN WITH AUTISM FACULTY DISCLOSURE
FACULTY DISCLOSURE INSIDE THE MIND OF A CHILD PSYCHIATRIST: PROBLEM BEHAVIORS IN CHILDREN WITH AUTISM KristinDawson, MD Assistant Professor University of Kentucky No commercial conflicts of Interest Salary
More informationChallenging ASD Cases November 11, Melanie Penner, MD, MSc, Mohammad Zubairi, MD, MEd,
Challenging ASD Cases November 11, 2017 Melanie Penner, MD, MSc, FRCPC @drmelpenner Mohammad Zubairi, MD, MEd, FRCPC @md_mszubairi Learning Objectives By the end of this workshop, participants will: 1)
More informationLow Functioning Autism Spectrum Disorder
Low Functioning Autism Spectrum Disorder Walter E. Kaufmann Center for Translational Research Greenwood Genetic Center Department of Neurology, Boston Children s Hospital MIT Simons Center for the Social
More informationTHE USE OF DIALECTICAL BEHAVIOR THERAPY WITH FORENSIC CLIENTS WITH AUTISM SPECTRUM DISORDER
THE USE OF DIALECTICAL BEHAVIOR THERAPY WITH FORENSIC CLIENTS WITH AUTISM SPECTRUM DISORDER DR JOSEPH ALLAN SAKDALAN AND SABINE VISSER CLINICAL FORENSIC AND NEUROPSYCHOLOGIST (NZ) APRIL 2018 OUTLINE OF
More informationAn Autism Primer for the PCP: What to Expect, When to Refer
An Autism Primer for the PCP: What to Expect, When to Refer Webinar November 9, 2016 John P. Pelegano MD Chief of Pediatrics Hospital for Special Care Disclosures None I will not be discussing any treatments,
More informationAutism Spectrum Disorder What is it?
Autism Spectrum Disorder What is it? Robin K. Blitz, MD Director, Developmental Pediatrics Resident Autism Diagnostic Clinic Lecture Series #1 Learning Objectives What can we talk about in 20 minutes?
More informationAutism 101 Glenwood, Inc. 2013
Autism 101 Glenwood, Inc. 2013 DSM-5 CURRENT DX CRITERIA Although ASD s are neurological, there are no current medical tests to use for a diagnosis. We currently use behavioral symptoms to make a diagnosis,
More informationHealth Care for People of all ages with Autism. Karen Ratliff-Schaub, M.D. Associate Professor, Clinical Pediatrics, Ohio State University
Health Care for People of all ages with Autism Karen Ratliff-Schaub, M.D. Associate Professor, Clinical Pediatrics, Ohio State University Overview DSM-5 Autism Spectrum Disorders Incidence Causes of ASD
More informationAutism Spectrum Disorders in DSM-5
Autism Spectrum Disorders in DSM-5 JILL FODSTAD, PH.D., HSPP, BCBA -D A S S I S TA N T P R O F E S S O R O F C L I N I C A L P SYC H O LO GY D E PA RT M E N T O F P SYC H I AT RY I U S C H O O L O F M
More informationStarting Strong 2015 Understanding Autism Spectrum Disorders and An Introduction to Applied Behavior Analysis
Starting Strong 2015 Understanding Autism Spectrum Disorders and An Introduction to Applied Behavior Analysis Robin Talley, M.Ed., BCBA UW Autism Center Presentation Overview Overview of Autism Spectrum
More informationOVERVIEW OF PRESENTATION
AUTISM SPECTRUM DISORDERS IN EMERGING ADULTS Douglas J. Scambler, Ph.D. Clinical Psychologist Presented at the University of Wyoming November 6, 2012 OVERVIEW OF PRESENTATION What are the autism spectrum
More informationAutism Spectrum Disorder What is it?
Autism Spectrum Disorder What is it? Robin K. Blitz, MD Resident Autism Diagnostic Clinic Lecture Series #1 Learning Objectives What can we talk about in 20 minutes? What is Autism? What are the Autism
More informationAutism Spectrum Disorder What is it? Robin K. Blitz, MD Resident Autism Diagnostic Clinic Lecture Series #1
Autism Spectrum Disorder What is it? Robin K. Blitz, MD Resident Autism Diagnostic Clinic Lecture Series #1 Learning Objectives What can we talk about in 20 minutes? What is Autism? What are the Autism
More informationINFORMATION PAPER: INTRODUCING THE NEW DSM-5 DIAGNOSTIC CRITERIA FOR AUTISM SPECTRUM DISORDER
INFORMATION PAPER: INTRODUCING THE NEW DSM-5 DIAGNOSTIC CRITERIA FOR AUTISM SPECTRUM DISORDER What is the DSM-5? The Diagnostic and Statistical Manual of Mental Disorders (the DSM) is developed by the
More informationSocial Communication Strategies for Students with ASD Meeting the Needs 2017
Social Communication Strategies for Students with ASD Meeting the Needs 2017 Leanne Forrest Case Manager, OCDSB ASD Team Michelle MacIsaac OCDSB Speech-Language Pathologist Julia Sneyd OCDSB Itinerant
More informationSURVEY OF AUTISM SPECTRUM DISORDER CONCERNS
Survey of Autism Spectrum Disorder Concerns Presented by Curtis L. Timmons, Ph.D., LSSP GOALS OF THE WORKSHOP 1. Understand why there were changes between the DSM-IV and the DSM-5 2. Understand the current
More informationDevelopmental Disorders also known as Autism Spectrum Disorders. Dr. Deborah Marks
Pervasive Developmental Disorders also known as Autism Spectrum Disorders Dr. Deborah Marks Pervasive Developmental Disorders Autistic Disorder ( Autism) - Kanner Asperger Syndrome Pervasive Developmental
More informationDiagnosing Autism, and What Comes After. Natalie Roth, Ph. D. Clinical Psychologist, Alternative Behavior Strategies
Diagnosing Autism, and What Comes After Natalie Roth, Ph. D. Clinical Psychologist, Alternative Behavior Strategies Cigna Autism Awareness Education Series, January 12, 2017 1 Autistic Spectrum Disorder
More informationRole of ADHD medication in children with autism spectrum disorder. Pieter Hoekstra University of Groningen, Netherlands
Role of ADHD medication in children with autism spectrum disorder Pieter Hoekstra University of Groningen, Netherlands Symptoms of ADHD are highly prevalent in children with ASD Two independent chart reviews
More informationMedications in Autism: What We Know and Don't Know
Medications in Autism: What We Know and Don't Know Jeremy Veenstra-VanderWeele, M.D. Mortimer D. Sackler, M.D., Associate Professor Center for Autism and the Developing Brain Sackler Institute for Developmental
More informationMedications for Anxiety & Behavior in Williams Syndrome. Disclosure of Potential Conflicts. None 9/22/2016. Evaluation
Medications for Anxiety & Behavior in Williams Syndrome Christopher J. McDougle, M.D. Director, Lurie Center for Autism Professor of Psychiatry and Pediatrics Massachusetts General Hospital and MassGeneral
More informationDisclosures. Autism Society of Wisconsin. Case 2. Case 1. Case 3. Case 4 3/29/2018. Medication treatment for people with Autism Spectrum Disorder
Medication treatment for people with Autism Spectrum Disorder Autism Society of Wisconsin April 20, 2018 Richard P. Barthel, M.D. Disclosures In accordance with the ACCME policy on relevant financial disclosure,
More informationTools that make a difference in mental health symptoms of autistic spectrum children Sumru Bilge-Johnson M.D. Program Director of Child Psychiatry
Tools that make a difference in mental health symptoms of autistic spectrum children Sumru Bilge-Johnson M.D. Program Director of Child Psychiatry Fellowship Associate Professor, Child Psychiatry NEOMED
More informationAutism or Something Else? Knowing the Difference
Autism or Something Else? Knowing the Difference SUSAN BUTTROSS, M.D., FAAP PROFESSOR OF PEDIATRICS CENTER FOR THE ADVANCEMENT OF YOUTH UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MISSISSIPPI Disclosure
More informationDSM- 5 AUTISM SPECTRUM DISORDER
DSM- 5 AUTISM SPECTRUM DISORDER A. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history A1. Deficits in social-emotional
More informationAutism. Laura Schreibman HDP1 11/29/07 MAIN DIAGNOSTIC FEATURES OF AUTISTIC DISORDER. Deficits in social attachment and behavior
Autism Laura Schreibman HDP1 11/29/07 MAIN DIAGNOSTIC FEATURES OF AUTISTIC DISORDER Deficits in social attachment and behavior Deficits in verbal and nonverbal communication Presence of perseverative,
More informationCourse # Understanding Autism
Course # 503 Understanding Autism Disclaimer Slide Understanding Autism Andrea Gregory, MD, FAAP Objectives The learner will understand what Autism Spectrum Disorder encompasses and how it manifests clinically
More informationAutism Update: Classification & Treatment
Autism Update: Classification & Treatment Dana Battaglia, Ph.D., CCC-SLP NYSUT Professional Issues Forum on Healthcare April 26 th, 2013 10:30-12:30 1 Who is here today? Our Goals for This Morning Introduce
More informationPiecing the Puzzle Together: Pharmacologic Approaches to Behavioral Management in Autism Spectrum Disorder
Piecing the Puzzle Together: Pharmacologic Approaches to Behavioral Management in Autism Spectrum Disorder Hannah Sauer, PharmD PGY1 Pediatric Pharmacy Resident Mayo Clinic 2015 MFMER slide-1 Objectives
More information8/23/2017. Chapter 21 Autism Spectrum Disorders. Introduction. Diagnostic Categories within the Autism Spectrum
Chapter 21 Overview Core features of autism spectrum disorders (ASDs) Studies seeking an etiology for ASDs Conditions associated with ASDs Interventions and outcomes Introduction ASDs Class of neurodevelopmental
More informationAutism Spectrum Disorder: An Update Kathleen A. Koth, D.O.
Autism Spectrum Disorder: An Update Kathleen A. Koth, D.O. Assistant Professor, Child and Adolescent Psychiatry Program Director, Child and Adolescent Psychiatry Fellowship President, Wisconsin Council
More informationTreatment of Autism Spectrum Disorder in Children and Adolescents
Evidence-Based Medicine Key Words: autism spectrum disorder, treatment, psychotherapy, psychopharmacology Treatment of Autism Spectrum Disorder in Children and Adolescents By Melissa DeFilippis, Karen
More informationEarly Screening of ASD & The Role of the SLP
Early Screening of ASD & The Role of the SLP Objectives Identify reasons for early identification Identify screenings tools that aid in identification of ASD Define the role of the SLP in screening & assessment
More information[INSERT TITLE] 2/24/19. Understanding Restricted and. Repetitive Behaviors in HFA. Kimberlee Flatt, PhD, LPC,BCBA/LBA DSM-5
Understanding Restricted and [INSERT TITLE] Repetitive Behaviors in HFA Kimberlee Flatt, PhD, LPC,BCBA/LBA DSM-5 B. Restricted, repetitive patterns of behavior, interests, or activities 1. Stereotyped
More information6/22/2012. Co-morbidity - when two or more conditions occur together. The two conditions may or may not be causally related.
Autism Spectrum Disorders and Co-existing Mental Health Issues By Dr. Karen Berkman Objective To present an overview of common psychiatric conditions that occur in persons with autism spectrum disorders
More information6/5/2018 SYLVIA J. ACOSTA, PHD
SYLVIA J. ACOSTA, PHD ASSOCIATE PROFESSOR SUMMER INSTITUTE JUNE 1 Introduction to Autism Spectrum Disorder (ASD) for Educators JUNE 15, 2018 2 Objectives Participants will: Identify the 2 diagnostic categories
More informationPsychopharmacology of Autism Spectrum Disorder
Psychopharmacology of Autism Spectrum Disorder Christopher J. McDougle, MD Director, Lurie Center for Autism Professor of Psychiatry and Pediatrics Massachusetts General Hospital and MassGeneral Hospital
More informationAutism Spectrum Disorder: A Primer for PCPs
Autism Spectrum Disorder: A Primer for PCPs Learning Objectives 1. Define current ASD diagnostic criteria 2. Identify ASD screening tools, including the M-CHAT-R/F 3. Describe treatments/interventions
More information1/30/2018. Adaptive Behavior Profiles in Autism Spectrum Disorders. Disclosures. Learning Objectives
Adaptive Behavior Profiles in Autism Spectrum Disorders Celine A. Saulnier, PhD Associate Professor Emory University School of Medicine Vineland Adaptive Behavior Scales, Third Edition 1 Disclosures As
More informationFrom: What s the problem? Pathway to Empowerment. Objectives 12/8/2015
Overcoming Intellectual Disability and Autism to Achieve Vocational & Academic Success Pathway to Empowerment Objectives 1 2 4 Learn to distinguish between intellectual disability and autism spectrum disorders.
More informationAdaptive Behavior Profiles in Autism Spectrum Disorders
Adaptive Behavior Profiles in Autism Spectrum Disorders Celine A. Saulnier, PhD Associate Professor Emory University School of Medicine Director of Research Operations Marcus Autism Center Vineland Adaptive
More informationAUTISM SCREENING AND DIAGNOSIS PEARLS FOR PEDIATRICS. Catherine Riley, MD Developmental Behavioral Pediatrician
AUTISM SCREENING AND DIAGNOSIS PEARLS FOR PEDIATRICS Catherine Riley, MD Developmental Behavioral Pediatrician Disclosure I do not have any financial relationships to disclose I do not plan to discuss
More informationAutism 101: An Introduction for Families
Autism 101: An Introduction for Families Lindsey Miller, ARNP Rachel Montague, Ph.D. June 5, 2012 Overview of Presentation What are Autism Spectrum Disorders? Prevalence & causes Characteristics & related
More informationAutism. Autism and autistic spectrum
Autism Autism is a disorder that affects the way a person communicates with and relates to other people. Most (but not all) people with autism also have a learning disability. People with autism need specialist
More informationNATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE Centre for Clinical Practice SCOPE
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE Centre for Clinical Practice 1 Guideline title SCOPE Autism: the management and support of children and young people on the autism spectrum 1.1 Short
More information4/2/13 COMMON CLASSES OF MEDICATIONS. Child & Adolescent Behavioral Medicine & Medication Therapies. Behavioral Medicine & Medication Therapies
Child & Adolescent Behavioral Medicine & Medication Therapies Brian J Cowles, PharmD Associate Professor of Pharmacy Practice Albany College of Pharmacy & Health Sciences; Vermont Campus Behavioral Medicine
More informationAutism: Practical Tips for Family Physicians
Autism: Practical Tips for Family Physicians Keyvan Hadad, MD, MHSc, FRCPC Alberta College of Family Physicians 61st Annual Scientific Assembly March 5, 2016 No conflict of interest Diagnosis and Misdiagnosis
More informationOklahoma Psychological Association DSM-5 Panel November 8-9, 2013 Jennifer L. Morris, Ph.D.
Oklahoma Psychological Association DSM-5 Panel November 8-9, 2013 Jennifer L. Morris, Ph.D. DSM-5 continues developmental progression, starting with disorders that are observed in early life. Disorders
More informationBrief Notes on the Mental Health of Children and Adolescents
Brief Notes on the Mental Health of Children and Adolescents The future of our country depends on the mental health and strength of our young people. However, many children have mental health problems
More informationWhat About Health 3: Challenging Behaviors
The title of this presentation is What About Health. I m. In this presentation I will discuss a number of health and mental health issues related to children with ASD. 1 Now I am going to switch to discussing
More informationWelcome. Rogers treats children, adolescents and adults with: Anxiety disorders Eating disorders Mood disorders Substance use disorders
Welcome Rogers treats children, adolescents and adults with: Anxiety disorders Eating disorders Mood disorders Substance use disorders 800-767-4411 rogershospital.org Major Changes in DSM-5 As it Relates
More informationWhat's New, What's Hot, What's In, What's Out? The DSM-5 and Special Education Law
What's New, What's Hot, What's In, What's Out? The DSM-5 and Special Education Law Attorney Paige L. Tobin, Murphy, Lamere & Murphy Naami S. Turk, Psy.D. 2 DSM-5: Why the changes? Goal: use most evidence-based
More informationCollaborative, evidence based understanding of students with ASD
Collaborative, evidence based understanding of students with ASD Rebecca Sutherland Speech Pathologist Child Development Unit Children s Hospital at Westmead Positive Partnerships www.positivepartnerships.com.au
More informationAutism beyond childhood. The Challenges
Autism beyond childhood The Challenges Why ASD and Why Now? Prevalence Historically emphasis has been on childhood Adults fall through cracks Poor services Government responses Pervasive Developmental
More informationTeaching Students with Special Needs in Inclusive Settings: Exceptional Learners Chapter 9: Autism Spectrum Disorders
Teaching Students with Special Needs in Inclusive Settings: Exceptional Learners Chapter 9: Autism Spectrum Disorders Background Autistic is a broad term coined in the twentieth century by Bleuler that
More informationAutism Spectrum Disorder (ASD)
Autism Spectrum Disorder (ASD) What is Autism Spectrum Disorder (ASD)? (*Please note that the diagnostic criteria for ASD according to the DSM-V changed as of May, 2013. Autism Spectrum Disorder now is
More informationDevelopmental Disabilities: Diagnosis and Treatment. Sara Sanders, Psy.D. 03/05/15
Developmental Disabilities: Diagnosis and Treatment Sara Sanders, Psy.D. 03/05/15 1 Developmental Disability A severe and chronic disability that is attributable to a mental or physical impairment that
More information5. Diagnostic Criteria
5. Diagnostic Criteria The questions that are going to be answered in this chapter are: What are the diagnostic criteria of ASD? Are the diagnostic criteria laid down in the DSM-IV-TR or ICD-10 manuals
More informationThe Nuts and Bolts of Diagnosing Autism Spectrum Disorders In Young Children. Overview
The Nuts and Bolts of Diagnosing Autism Spectrum Disorders In Young Children Jessica Greenson, Ph.D. Autism Center University of Washington Overview Diagnostic Criteria Current: Diagnostic & Statistical
More informationAutism Grows Up: Transitions to Adulthood. Elizabeth Reeve MD, HealthPartners Medical Group
Autism Grows Up: Transitions to Adulthood Elizabeth Reeve MD, HealthPartners Medical Group Agenda Brief overview Transition issues Impact on person with autism Impact on the family Community resources
More informationAutism Spectrum Disorders. Erin McFarland, M.Ed., LPC November 1, 2012
Autism Spectrum Disorders Erin McFarland, M.Ed., LPC November 1, 2012 What are Autism Spectrum Disorders (ASD)? Range of complex neurodevelopmental disorders characterized by social impairments, communication
More informationTSC AND AUTISM SPECTRUM DISORDERS
TSC AND AUTISM SPECTRUM DISORDERS First described in 1943 as a syndrome impacting behavior, autism is typically diagnosed in early childhood,. The new Diagnostic and Statistical Manual of Mental Disorders,
More informationManagement of Children With Autism Spectrum Disorders
CLINICAL REPORT Management of Children With Autism Spectrum Disorders Guidance for the Clinician in Rendering Pediatric Care Scott M. Myers, MD, Chris Plauché Johnson, MD, MEd, the Council on Children
More informationAutism in the United States: By the Numbers
Autism in the United States: By the Numbers Current Trends in Autism Spectrum Disorder Eric Kurtz, Ph.D. Director, Leadership Excellence in Neurodevelopmental Disorders Director of Clinical Operations
More informationBob Klaehn, M.D. Bob Klaehn, M.D. October 3, /30/14
Bob Klaehn, M.D. October 3, 2014 1 Bob Klaehn, M.D. Medical Director, Arizona Division of Developmental Disabilities since 2001 Faculty, MIHS Child Psychiatry Residency Program Child Psychiatrist, District
More informationAgenda. Making the Connection. Facts about ASD. Respite Presentation. Agenda. Facts about ASD. Triad of Impairments. 3 Diagnoses on spectrum
Making the Connection Respite Presentation Agenda Agenda Facts about ASD Triad of Impairments 3 Diagnoses on spectrum Characteristics of ASD Behaviour Facts about ASD It is the most common form of any
More informationInstructional Practices for Students with Autism A.. Kimberly Howard M.Ed.
Instructional Practices for Students with Autism A. Kimberly Howard M.Ed. The mission of the Kentucky Autism Training Center is to strengthen our state's systems of support for persons affected by autism
More informationDifferential Diagnosis. Differential Diagnosis 10/29/14. ASDs. Mental Health Disorders. What Else Could it Be? and
Differential Diagnosis ASDs and Mental Health Disorders - Matt Reese, PhD Differential Diagnosis What Else Could it Be? Differential Diagnosis: The process of distinguishing one disorder from others which
More informationWHAT IS AUTISM? Chapter One
WHAT IS AUTISM? Chapter One Autism is a life-long developmental disability that prevents people from understanding what they see, hear, and otherwise sense. This results in severe problems with social
More informationCorrespondence should be addressed to Vitharon Boon-yasidhi;
Psychiatry Journal, Article ID 136158, 4 pages http://dx.doi.org/10.1155/2014/136158 Research Article Adverse Effects of Risperidone in Children with Autism Spectrum Disorders in a Naturalistic Clinical
More informationIndex. Note: Page numbers of article titles are in boldface type. A ADHD. See Attention-deficit/hyperactivity disorder (ADHD) b-adrenergic blockers
Note: Page numbers of article titles are in boldface type. A ADHD. See Attention-deficit/hyperactivity disorder (ADHD) a-adrenergic blockers for PTSD, 798 b-adrenergic blockers for PTSD, 798 Adrenergic
More informationAutism. Tara Anne Matthews, MD Fellow Kapila Seshadri, MD Associate Professor of Pediatrics UMDNJ Robert Wood Johnson Medical November 28, 2012
Autism Tara Anne Matthews, MD Fellow Kapila Seshadri, MD Associate Professor of Pediatrics UMDNJ Robert Wood Johnson Medical November 28, 2012 Why Talk about Autism -Prevalence 1 in 6 children (17 %) diagnosed
More informationPsychiatric Medications. Positive and negative effects in the classroom
Psychiatric Medications Positive and negative effects in the classroom Teaching the Medicated Child Beverly Bryant, M.D. Hattiesburg Clinic 9/17/14 Introduction According to the National Survey of Children
More informationPHARMACOLOGICAL THERAPY OF AUTISM SPECTRUM DISORDERS IN THE CLINICAL PRACTICE
ANTON et al. ORIGINAL PAPERS PHARMACOLOGICAL THERAPY OF AUTISM SPECTRUM DISORDERS IN THE CLINICAL PRACTICE Andra ISAC 2, Magdalena KWASIUK 1, Roxana ȘIPOȘ 1, Ioana MICLUȚIA 1, Viorel LUPU 1, Elena PREDESCU
More informationNEW AND REVISED DSM DISORDERS. Disruptive Mood Dysregulation Disorder Autism Spectrum Disorders Substance Use Disorders
NEW AND REVISED DSM DISORDERS Disruptive Mood Dysregulation Disorder Autism Spectrum Disorders Substance Use Disorders Objectives 1. Identify the rationale for the Disruptive Mood Dysregulation Disorder
More informationThe Autism Spectrum Disorders: Interventions
The Autism Spectrum Disorders: Interventions Isabelle Rapin Albert Einstein College of Medicine Bronx NY USA No Conflict of Interest Vienna, October 2007 Definitions Three terms I use interchangeably Autism
More informationDisclosure Statement. A Rational Approach to Psychopharmacology. Goals 10/28/2013
A Rational Approach to Psychopharmacology Disclosure Statement Full time employed physician with MaineGeneral Medical Center in Waterville and Augusta No conflicts of interest to disclose Goals Promote
More informationPervasive Developmental Disorder Not Otherwise Specified (PDD- NOS)
Pervasive Developmental Disorder Not Otherwise Specified (PDD- NOS) What is Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS)? (*Please note that the criteria according to the DSM-V changed
More informationAutism Spectrum Disorder and Visual Impairment Revisited.
Autism Spectrum Disorder and Visual Impairment Revisited. How can standardised assessment tests be adapted to assist in providing a robust diagnosis of Autism Spectrum Disorder in children who are blind
More informationAlpha-2 Agonists. Antipsychotics
Table 5: Randomized Controlled Trials of Psychotropic Medications in Children and Adolescents with ASD Agent Study Target Symptoms Dose Demographics Significant Side Clonidine Guanfacine Jaselskis et al.,
More informationAutism 101. Joseph Falkner, MST/CCC-SLP
Autism 101 Joseph Falkner, MST/CCC-SLP Introduction Activity The Monkey Business Illusion: http://www.youtube.com/watch?v=igqmdok_zfy Heider Simmel Cartoon: http://vimeo.com/36847727 Micro-expression Training
More informationCHILD & ADOLESCENT PSYCHIATRY ALERTS, VOLUME XIV, 2012 INDEX
A Adderall Counterfeit, 31 addiction, internet CBT, 55 ADHD Adjunctive Guanfacine, 11 Counterfeit Adderall, 31 Developmental Trajectory and Risk Factors, 5 Dopamine Transporter Alterations, 14 Extended-Release
More informationCommon Mental Health Needs for Students with Autism. Kim Selders & Dr. Kerri Nowell
Common Mental Health Needs for Students with Autism Kim Selders & Dr. Kerri Nowell Overview Common co-occurring mental health concerns with autism Common treatments for mental health needs Mental health
More information